Bronchogenic carcinoma and thromboembolic disease

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Abstract
During a 6-year period, thromboembolism occurred as an early complication in 37 patients with primary broncho-genie carcinoma. No other precipitating factor was identified, and only 3 of the 37 patients had previously undergone surgery. In 14 instances, an episode of thrombophlebitis 1st called attention to the patient''s illness. Migratory thrombophlebitis involving unusual sites and resistant to anticoagulant therapy often preceded recognition of the tumor by as long as 18 months. The presence of thrombophlebitis was associated with a poor prognosis. The mechanism is obscure, but in 3 cases there was acceleration of factor III (thromboplastin) generation. No relationship was apparent between the histologic structure of the tumor and the frequency of venous thromboembolism. Even when lymph nodes are not palpable, bilateral supraclavicular exploration and lymph node biopsy appears to be a valuable and innocuous diagnostic procedure in patients with unexplained thrombophlebitis and is preferable to abdominal exploration. The true incidence of this complication is difficult to assess because of the uncertainties of retrospective diagnosis and follow-up.

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